Is It Multiple Sclerosis?

Diagnosing multiple sclerosis (MS) can be trickier than one would think. There is not a single test that can be used by itself to rule in or rule out an MS diagnosis. Rather, an entire profile is developed based on medical history, a neurologic exam, and lab tests (including an MRI, evoked potentials, and spinal fluid analysis) that rule out other conditions and reaffirm the likelihood of MS.

After testing points to MS as being likely, it’s important for clinicians to review the patient profile to ensure that another disease that causes demyelination is not present. These include neuromyelitis optica spectrum disorder and acute disseminated encephalomyelitis. In addition, non-demyelinating disorders such as chronic small vessel disease and other disorders that can mimic MS (e.g., inflammatory, granulomatous, infective, metabolic, and genetic causes) need to be ruled out. In general, it’s more straight-forward to diagnose relapsing-remitting MS, while progressive MS can be trickier to diagnose.

As upsetting as a diagnosis of MS can be, many patients actually experience a measure of relief from knowing – finally – what disease they have after what can be months or even years of symptoms with no diagnosis. Getting support from loved ones, a support group, or a therapist can be important in adjusting to a new diagnosis.

Fortunately, over the past two decades there has been significant progress in treatment options for MS. Interventions that increase the time between relapses and help limit disability are seeing therapeutic success. A growing variety of therapies have been approved for the relapsing-remitting forms of MS, although (sadly) options for progressive MS remain limited.